Balloon aortic valvuloplasty in elderly patients: a review and update

Eles, Gustav; Khalil, Ramzi; Lasorda, David; Spotti, Jennifer

doi:10.2217/ica.13.7

Cited by 1 publication

(1 citation statement)

References 35 publications

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“…In patients initially deemed as poor candidates for SAVR/TAVR and successfully undergo BAV resulting in improved hemodynamics, it may be possible to bridge these patients to more permanent solutions such as SAVR/TAVR [25]. Similarly, BAV can be used to evaluate if a patient will benefit from valve replacement when other comorbidities exist such as severe pulmonary hypertension, severe lung disease, a poor ejection fraction, or frailty with a transient improvement [26][27][28][29][30]. Limited information regarding bridging patients to SAVR/TAVR with BAV currently exists and more information needs to be obtained, especially as individuals are living longer and calcific aortic stenosis being inevitable.…”

Section: Discussionmentioning

confidence: 99%

In-Hospital Mortality after Balloon Aortic Valvuloplasty

Raj¹

2017

JOCCT

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Background: Surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) have been shown to improve symptoms and overall survival in patients with severe, symptomatic aortic stenosis (AS). However, there still remains a group of patients not considered as appropriate candidates due to comorbid conditions and/or hemodynamic instability. The purpose of this study is to evaluate the in-hospital mortality of this high risk group undergoing BAV.Methods: An institutional BAV registry was created to compare baseline clinical characteristics with treatment outcomes and its associations with in-hospital mortality. Univariate analyses for continuous variables were performed with analysis of variance and Mann Whitney tests. Univariate analyses for categorical variables were preformed with Pearson chi square and Fischer's exact test. Multivariate logistic regression analyses were performed with variables statistically significant within the in-hospital mortality group. Results:This retrospective, single-center cohort included 68 patients who underwent BAV with 10 patients (15%) having post-procedural in-hospital mortality. The surviving patients had an average body mass index (BMI) of 25.8 (range 20.9-36.7) as opposed to the in-hospital mortality group with a BMI of 20.2 (range 16.8-22.9). The in-hospital mortality group has significantly higher rates of acute kidney injury (1.3±0.5 vs 2.3±2, P <0.003) prior to procedure, significantly elevated pulmonary artery pressures (45±10 vs 28±12mmHg, P<0.01), and elevated left ventricular end diastolic pressures (28±11 vs 23±23mmHg, P<0.047) when compared to the survival group. Conclusion:Developments in technique with the use vascular closure devices, catheters with smaller sheath sizes, and the use of rapid ventricular pacing has lead to improved outcomes when compared to prior registries. Limited information regarding bridging patients to SAVR/ TAVR with BAV currently exists and more information needs to be obtained, especially as individuals are living longer and aortic stenosis being inevitable.

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Section: Discussionmentioning

confidence: 99%

In-Hospital Mortality after Balloon Aortic Valvuloplasty

Raj¹

2017

JOCCT

View full text Add to dashboard Cite

show abstract

Balloon aortic valvuloplasty in elderly patients: a review and update

Cited by 1 publication

References 35 publications

In-Hospital Mortality after Balloon Aortic Valvuloplasty

In-Hospital Mortality after Balloon Aortic Valvuloplasty

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